Acute Myocardial Infarction, What is the main cause of a myocardial infarction? What is the difference between a heart attack and a myocardial infarction? What are the 4 silent signs of a heart attack?

Nursing

Myocardial infarction refers to a dynamic process by which one or more regions of myocardium experience prolonged decrease in oxygen supply because of insufficient coronary blood flow causing necrosis of tissue.

Causes

* Occlusion of a coronary artery

* Streneous physical activity

* Emotional stress such as anger

* Exposure to cold

* Thrombus formation

Signs & Symptoms

* Chest pain radiating to one or both arms, neck and back

* Dyspnea or orthopnea

* Shortness of breath

* Anxiety

* Systolic blood pressure less than 80 mm of Hg

* Tachycardia or bradycardia

* Weakness, cold, sweat, pallor

* Palpitation

* Peripheral cyanosis

* Nausea or vomiting

Investigations

* 12 lead ECG

* Echocardiography

* Trop-I

* serum CPK-MP and (CPK)

* Lipid Profile

* ESR

Management

Medical Management

* Nitrates – help to relieve pain

* Calcium channel blockers – prevents vasodilation

* Beta-blockers

* Morphine-act as analgesics and sedatives

* Oxygen supply

* Heparin therapy

* Antiplatelet therapy

Sugical Management

* Angioplasty

* CABG

Nursing Management

* Provide proper rest

* Assess for previous health history regarding allergic medications, trauma etc

* Reassure the patient

* Monitor the vital signs

* Administer thrombolytic therapy

* Administer oxygen as required

* Assess the characteristic of chest pain including location, duration, and quality.

* Maintain intake output chart

* Instruct to avoid alcohol, smoking and physical activity

* Educate the patient to change life style and rehabilitation

Complication

* Pulmonary embolism

* Pericarditis

* Shock

* Mitral incompetence

* Heart failure

* Rupture of the heart

* Phlebothrombosis

* Angina pectoris

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